Local anesthetic systemic toxicity

@article{Dillane2010LocalAS,
  title={Local anesthetic systemic toxicity},
  author={Derek Dillane and Brendan T Finucane},
  journal={Canadian Journal of Anesthesia/Journal canadien d'anesth{\'e}sie},
  year={2010},
  volume={57},
  pages={368-380}
}
  • D. Dillane, B. Finucane
  • Published 2010
  • Medicine
  • Canadian Journal of Anesthesia/Journal canadien d'anesthésie
PurposeThe practice of regional anesthesia has been revitalized of late with the popularization of ultrasound-guided techniques. [...] Key MethodSourcesA search of the English language literature was conducted using the PubMed database from the National Library of Medicine. Bibliographies of retrieved articles were used to retrieve additional articles.Principal findingsThe advent of multiple safety steps has led to a dramatic reduction in the incidence of local anesthetic toxicity over the past 30 years. Rising…Expand

Paper Mentions

Interventional Clinical Trial
Introduction: The risk of systemic toxicity when using bupivacaine is a persistent problem, making its pharmacokinetic study crucial to the safety of regional anesthesia (RA). Little… Expand
ConditionsAnesthetics, Local, Pharmacokinetics
InterventionDrug
LOCAL ANAESTHETIC SYSTEMIC TOXICITY: CURRENT CONCEPTS AND
TLDR
This narrative review summarizes the pharmacology of local anesthetics, clinical manifestations of systemic toxicity associated with these agents, necessary preventive measures and recent treatment strategies. Expand
Cardiac toxicity after intraurethral instillation of lidocaine: A case report and review of literature
TLDR
Outpatient flexible cystoscopy is a common procedure done in outpatient clinics and is usually associated with some discomfort and 2% lidocaine gel is widely used as a local anesthetic lubricant before various forms of transurethral instrumentation. Expand
Systemic adverse reactions to local anesthetics
TLDR
If you experience systemic adverse reactions to the local anesthetic, the biggest problem in clinical practice, is a recognition of the nature of adverse reactions and providing appropriate therapy in conjunction with the resulting reaction. Expand
Toxicity of local anaesthetic agents
TLDR
The most significant advancement in the treatment of local anaesthetic toxicity is the introduction of lipid emulsion, however, there still have a few case reports of successful use and the mechanism of action is yet to be clarified. Expand
Local anesthetic systemic toxicity (LAST) - Should we not be concerned?
TLDR
There is a need to increase the awareness about LAST and establish a protocol to treat any serious neuro or cardiotoxicity and the role of lipid emulsion in treating it. Expand
The Science of Local Anesthesia: Basic Research, Clinical Application, and Future Directions.
TLDR
The 2 main research avenues being followed to improve action of local anesthetics are to prolong duration of block, by slow-release formulations and on-demand release, and to develop compounds and combinations that elicit a nociception-selective blockade. Expand
Thirty years after the bupivacaine controversy: what have we learned?
TLDR
In this issue of the Journal, Dillane and Finucane review the systemic toxicity of LAs, describing the mechanisms underlying central nervous system and cardiovascular toxicity associated with elevated plasma levels of L as and suggest that there are benefits from the use of ultrasound during the performance of regional anesthesia. Expand
Local anaesthetic toxicity
TLDR
A brief overview of the current understanding of the circumstances that cause systemic and cardiovascular toxicity in the daily clinical practice and the management of clinical signs and symptoms is offered. Expand
Systemic toxic effects of local anaesthetics
TLDR
Awareness of LAST and vigilance during administration of local anaesthetics may help in early recognition and successful management of the toxicity. Expand
Systemic local anaesthetic toxicity from continuous thoracic paravertebral block.
TLDR
A case of systemic local anaesthetic toxicity from continuous paravertebral block administration after thoracotomy and lobectomy leading to seizure, aspiration, and ultimately, death is reported. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 127 REFERENCES
Pharmacology of Local Anesthetic Agents
TLDR
The toxicity of local anesthetic drugs is usually due to inadvertent rapid intravascular injection or extravascular administration of an excessive amount, and signs and symptoms of CNS excitation followed by depression are the most common manifestations. Expand
Local Anesthetic-Induced Cardiac Toxicity: A Survey of Contemporary Practice Strategies Among Academic Anesthesiology Departments
TLDR
There are differences in the management and preparedness for treatment of LA toxicity among institutions, but the safety implications of these differences are undetermined. Expand
Convulsions associated with pediatric regional anesthesia.
  • C. Berde
  • Medicine
  • Anesthesia and analgesia
  • 1992
TLDR
A group of pediatric anesthesiologists chose to pool data concerning pediatric regional anesthetic complications and to develop a multicenter data base to help to prevent similar complications from occurring in other patients. Expand
Maximum Recommended Doses of Local Anesthetics: A Multifactorial Concept
TLDR
Conditions (eg, end-stage pregnancy, high age in epidural, or spinal block) or diseases (uremia) that may increase the rate of the initial uptake of the local anesthetic are indications to reduce the dose in comparison to one normally used for young, healthy, and nonpregnant adults. Expand
Current Concepts in Resuscitation of Patients With Local Anesthetic Cardiac Toxicity
  • G. Weinberg
  • Medicine
  • Regional Anesthesia & Pain Medicine
  • 2002
TLDR
Local anesthetics can interfere with cellular metabolism and homeostasis, particularly cell signalling systems and energy transduction pathways, and potentially interact with many different cell membranes, organelles, and a host of membrane-bound and cytosolic, charged molecules. Expand
Local Anesthetic Toxicity
TLDR
In this chapter, the most frequent toxic effect of local anesthetics — local anesthetic systemic toxicity — will be covered, as will the less-frequent clinical situations of allergy to localAnesthetics and myelotoxicity. Expand
Local anesthetics in infants and children: an update
  • C. Berde
  • Medicine
  • Paediatric anaesthesia
  • 2004
TLDR
Predictions regarding maximum safe infusion rates for infants and children have been largely supported by subsequent pharmacokinetic studies of prolonged epidural infusions in infants. Expand
Complications and local anaesthetic toxicity in regional anaesthesia
  • B. Veering
  • Medicine
  • Current opinion in anaesthesiology
  • 2003
TLDR
Current evidence suggests that ropivacaine is slightly less toxic than levobupvacaine; however, the difference in potency between the two agents is greater, and the new local anaesthetic agents can be regarded as ‘safer’, but must not be regardedAs safe. Expand
Levobupivacaine: a new safer long acting local anaesthetic agent.
TLDR
Levobupivacaine, the single enantiomer version of bupivacane, offers a new long acting local anaesthetic, clinically equivalent in anaesthetic potency to bupavicaine, but with a reduced toxicity profile. Expand
...
1
2
3
4
5
...